Exposure to multiple indoor allergens in US homes and relationship to asthma

National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA.
The Journal of allergy and clinical immunology (Impact Factor: 11.48). 04/2008; 121(3):678-684.e2. DOI: 10.1016/j.jaci.2007.12.1164
Source: PubMed


The National Survey of Lead and Allergens in Housing was the first population-based study to measure indoor allergen levels in US homes.
We characterized the overall burden to multiple allergens and examined whether increased allergen levels were associated with occupants' asthma status.
This cross-sectional study surveyed a nationally representative sample of 831 housing units in 75 different locations throughout the United States. Information was collected by means of questionnaire and environmental assessment. Allergen concentrations in dust samples were assessed by using immunoassays. The following cutoff points were used to define increased allergen levels: 10 microg/g for Der p 1, Der f 1, and Can f 1; 8 microg/g for Fel d 1; 8 U/g for Bla g 1; 1.6 microg/g for mouse urinary protein; and 7 microg/g for Alternaria alternata antigens. Allergen burden was considered high when 4 or more allergens exceeded increased levels in any of the sampling locations.
Exposure to multiple allergens was common in US homes. Of the surveyed homes, 51.5% had at least 6 detectable allergens and 45.8% had at least 3 allergens exceeding increased levels. Race, income, housing type, absence of children, and presence of smokers, pets, cockroaches, rodents, and mold/moisture-related problems were independent predictors of high allergen burden. Among atopic subjects, high allergen burden increased the odds of having asthma symptoms (odds ratio, 1.81; 95% CI, 1.04-3.15).
Increased allergen levels in the home are associated with asthma symptoms in allergic individuals.

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Available from: Peter S Thorne
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    • "L'exposition aux allergènes d'intérieur est impliquée dans la maladie allergique des voies respiratoires [2] [3] et contribue à la morbidité asthmatique. Cette exposition aux allergènes doit être évaluée non seulement à domicile mais aussi à l'école et au travail, où nous passons une grande partie de notre temps. "
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    ABSTRACT: Indoor allergen exposure is implicated in allergic respiratory disease and contributes to asthma morbidity. Mouse allergen plays a role in allergic asthma morbidity. However, no study is available on the distribution of this allergen in French public buildings.Methods Forty-six dust samples, collected by vacuuming during 2 different seasons, on the floor of five French public buildings in PACA region. They were divided into two subgroups (small and big structures), allowed to analyze five indoor allergens, with Multiplex ARray for Indoor Allergens™. A visual inspection and a questionnaire about the building and rooms were performed.ResultsMus m1, Fel d1, Can f1, Bla g2, Rat n1 were found in 93%, 87%, 61%, 35% and 7% of the dust samples with a median concentration (range) at 19.6 ng/g (0.2–6454.2), 37.9 ng/g (2.4–841.2), 28.2 ng/g (2.4–484.8), 188 ng/g (20.8–527.8) and 3.8 ng/g (3.8–12.8), respectively. All these allergens were positively correlated two by two, except for Mus m1. In the small and big structures, the median level of Mus m1 is 0.5 ng/g and 31.8 ng/g, respectively (P < 0.0001). Rat n1 was only present in big structures, with a median level at 3.8 ng/g. Deratting was more often used in big structures (P < 0.005). Mouse droppings were not associated with detection of Mus m1.Conclusion The prevalence of mouse allergen was substantial but their levels were most often very low. Mus m1 does not appear a major risk factor for asthma morbidity in PACA region.
    Full-text · Article · Nov 2014 · Revue Française d'Allergologie
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    • "Moreover, despite the significant amount of information regarding individual-level risk factors for allergic diseases, few studies have focused on household-level dynamics of allergic diseases based on household-level environmental and behavioral risk factors.33,34 Therefore, the aim of this study was to determine which "household-level" risk factors affect the prevalence of 3 allergic diseases (AD, asthma, and AR) among low-income households in Seoul, focusing on housing and behavioral characteristics. "
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    ABSTRACT: Purpose Indoor risk factors for allergic diseases in low-income households in Korea have been characterized only partially. We evaluated the prevalences of atopic dermatitis, asthma, and allergic rhinitis in Seoul, Korea, to identify key housing and behavioral risk factors of low-income households. Methods Statistical analysis of the prevalence of these diseases and various risk factors was conducted using data from a 2010 Ministry of Environment household survey. Logistic regression models were generated using data from 511 low-income household apartments in districts of Seoul. Results In general, housing factors such as renovation history (P<0.1) and crowding status (P<0.01) were associated with allergic rhinitis, whereas behavioral factors such as frequency of indoor ventilation (P<0.05) and cleaning (P<0.1) were inversely correlated with atopic dermatitis. Indoor smoking was a major trigger of asthma and atopic dermatitis in low-income households (P<0.05). The presence of mold and water leakage in houses were the most important risk factors for all three diseases (P<0.05). Conclusions Various risk factors play a role in triggering allergic diseases among low-income households in Seoul, and health or environmental programs mitigating allergic diseases should be tailored to address appropriate housing or behavioral factors in target populations.
    Full-text · Article · Sep 2014 · Allergy, asthma & immunology research
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    • "Factors that contribute to poor indoor environmental housing quality have been shown to be inextricably linked with poor asthma control.6,13 For example, biologic agents and housing conditions rank highly among environmental factors implicated in asthma morbidity, and may include indoor allergens from cockroaches,14,15 rodents,16,17 house-dust mites,18–20 animal dander, and fungi.21–24 A home with a relative humidity (Rh) level above 60% may create excess moisture, supporting the growth of mold, mold spores, and providing a favorable environment for dust mites.13 "
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    ABSTRACT: OBJECTIVE Asthma is the most common chronic childhood condition affecting 6.3 million (US) children aged less than 18 years. Home-based, multi-component, environmental intervention studies among children with asthma have demonstrated to be effective in reducing asthma symptoms. In this study, a local hospital and university developed an environmental intervention research pilot project, Eastern Carolina Asthma Prevention Program (ECAPP), to evaluate self-reported asthma symptoms, breathing measurements, and number of asthma-related emergency department (ED) visits among low-income, minority children with asthma living in rural, eastern North Carolina. Our goal was to develop a conceptual model and demonstrate any asthma respiratory improvements in children associated with our home-based, environmental intervention. METHODS This project used a single cohort, intervention design approach to compare self-reported asthma-related symptoms, breathing tests, and ED visits over a 6 month period between children with asthma in an intervention study group (n = 12) and children with asthma in a control study group (n = 7). The intervention study group received intense asthma education, three home visits, 2 week follow-up telephone calls, and environmental intervention products for reducing asthma triggers in the home. The control group received education at baseline and 2 week calls, but no intervention products. RESULTS At the end of the study period, significant improvements were observed in the intervention group compared with the control group. Overall, the intervention group experienced a 58% (46 ± SD 26.9) reduction in self-reported asthma symptoms; 76% (34 ± SD 29.7) decrease in rescue medicine; 12% (145 ± SD 11.3) increase in controller medicine; 37% decrease in mean exhaled nitric oxide levels and 33% fewer ED asthma-related visits. CONCLUSION As demonstrated, a combination of efforts appeared effective for improving asthma respiratory symptoms among children in the intervention group. ECAPP is a low cost pilot project that could readily be adapted and expanded into other communities throughout eastern North Carolina. Future efforts could include enhanced partnerships between environmental health professionals at local health departments and pediatric asthma programs at hospitals to carry out ECAPP.
    Full-text · Article · Jun 2014 · Environmental Health Insights
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